DEBATES OVER THE CAUSES
& DIAGNOSIS OF AUTISM

There is considerable disagreement over the exact
nature of Autism,
however it is generally considered to be a neurodevelopmental condition
which manifests itself in markedly abnormal social interaction,
communication ability, patterns of interests, and patterns of behavior.
It encompasses a wide range of atypical conditions, none of which
is well understood. Although there are common and specific physical
conditions comorbid to Autism Spectrum Disorders, not all people
diagnosed with Autism Spectrum Disorders experience these. The diagnostic
criteria, as of 2007, are still generally limited to psychiatric
and cognitive evaluation methods with IQ score and a particular
patterns of abilities (common to those with Autism) featuring strongly
in the formal diagnosis of Autism and distinguishing it from Asperger’s
Syndrome at the time of diagnosis.

DEBATE OVER CAUSES OF Autism

The cause(s)
of Autism and the spectrum of pervasive developmental disorders
(PDDs) are as yet unknown, as are the long-term
outlooks, or best early
intervention options. There is, however, widespread agreement
that early diagnosis and intervention can often make a significant
difference for the long-term prospects of a person with Autism because
the human mind and nervous system are more plastic at a younger
age; therefore, research for possible therapies and treatments is
often focused toward children who have been diagnosed early with
a spectrum disorder. However, many adults on the autism spectrum, as well as other interested parties, believe that
this emphasis on the problems facing children has resulted in limited
research and treatment options for adults with autism.

Today's medical community considers Autism to
be essentially incurable, or at least to have life-long effects.
Meanwhile, judging by the plethora of material on the Internet and
elsewhere, many autism spectrum adults and neurotypical (non-autistic)
allies in the autism rights movement do not consider Autism to be
a disorder, but simply a different way of perceiving and behaving.
These people believe that at least some of the difficulties encountered
by people with Autism may result from prejudice and lack of accommodation
from society.

With knowledge being so limited and scientific
progress so slow, nearly all conjectures about Autism are hotly
debated. Parents of autistic kids face a bewildering set of choices
and attendant uncertainty about the merits of various diagnoses,
prognoses, and alleged cures and treatments.

diagnosis of Autism

The 1994 DSM-IV
criteria for the diagnosis of Autism are the result of several
revisions, and consequently the psychiatric community is divided
as to whether the condition should be ordered by severity along
a spectrum or categorized into multiple distinct disorders that
have similar symptoms. This division is exacerbated by the wide
range of conditions comorbid to Autism spectrum disorders. Research
and clinical experience suggests that, while Autism may appear to
manifest itself as a psychiatric disorder, its underlying causes
are neurological. Pervasive Developmental Disorder, or PDD, has
emerged as an overarching descriptive term for the cluster of disorders
that includes Autism.

LACK OF DEFINITIVE TEST FOR Autism

A diagnosis of Autism is complicated by the fact
that there is no definitive test for Autism due to the significant
variance of symptoms among people with autistic traits, as well
as a lack of knowledge about the etiology of the condition. Those
with Asperger syndrome may be highly functional cognitively but
lack ‘social’ skills, whereas others with so-called “profound Autism”
may be non-verbal and deficient in elementary skills. Some autistic
people are considered mentally retarded, having low IQs (Intelligence
Quotients), while some have been ultimately found to have average
or above average intelligence. A minority of people with Autism
even have narrow, but exceptional autistic savant abilities.

This is not just an academic issue - treatment
strategies and choices are based on definitions of what needs to
be changed. Different treatment approaches have had widely divergent
outcomes depending on each specific person. For example, some parents
claim their children recovered with only behavioral approaches,
some credit biomedical intervention as the best method for improvement,
and others report little or no progress after trying many different
approaches. Occasionally, parents claim their autistic children
have simply “grown out of it”.

There are also those (primarily those on the autism spectrum themselves) who reject the premise that Autism is necessarily
a disorder that should be cured. In their view, a diagnosis can
sometimes result from a judgment of non-conformity that is followed
by efforts to correct what are essentially personality traits.

diagnostic issues for Asperger’s Syndrome and Autism

Currently, Asperger’s syndrome is classified as
a separate diagnosis from Autism in the DSM-IV, but it is still
considered an Autism spectrum disorder. The primary distinction
between the definitions of Autism and Asperger’s Syndrome in the
DSM-IV is that Autism involves a speech delay and Asperger’s does
not. Many people believe Autism and Asperger’s syndrome should not
be given separate labels in the DSM-IV because they believe that
differences in language acquisition are not significant enough to
separate the disorders or that Autism and Asperger’s have no definitive
differences. It is also unclear whether a child with high-functioning
autism who learns to speak should have their diagnosis changed
to that of Asperger’s Syndrome though it should be noted that late
speech does occur in a minority of neurotypical children and, in
itself, need not be indicative of Autism in a child with Asperger’s
Syndrome who goes on to develop good functional language.

Non-medical views

Autism is not a disorder

There is a view that autism is not a disorder,
but a normal, healthy variation in neurological hard-wiring, and
therefore does not need to be cured. This "anti-cure perspective"
supports the model of autism that claims that autism is a fundamental
part of who the autistic person is and that autism is something
that cannot be separated from the person.

A cure is seen as destroying the original personality
of the individual and is perceived similar to attempts to "cure"
homosexuality, therefore this perspective considers the disease
classification insulting. In line with this belief an autistic culture
has begun to develop similar to deaf culture. This view is usually
held by autistic people themselves (Autism rights movement), and
is mostly criticized by parents of autistic children.

There is no one condition called Autism

This view was put forward by autistic author Donna
Williams in her ninth book in the autism field, The Jumbled
Jigsaw, based on her work as an autism consultant working with
over 600 people on the spectrum over 8 years. Here she presented
a holistic model called Autism as a fruit salad model and demonstrated
how the severity of someone's Autism could be linked to their degree
of co-morbid communication, sensory-perceptual, gut/immune, neurological
integration, mood, anxiety and compulsive disorders a person inherited
or developed coupled with cognitive and learning style differences
and unusual personality trait collections.

She suggested these challenges came about via
different combinations of pathways including genetic inheritance,
toxic exposure and clashing socio/sensory environments. She suggested
that treatment and management, therefore, depended on mapping out
which collection of co-morbid challenges were underpinning the autistic
presentation for different individuals and addressing each with
the most appropriate approaches to each individual underlying issue
to maximize each person's potential. She also acknowledged that
within this framework, individuals would exist for whom their greatest
challenge would be cultural clashes between themselves and the neurotypical
world.

Click here for the full
range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an Autism and Asperger's
syndrome-related articles at http://en.wikipedia.org